Dr. Smith's ECG Blog

MARCH 9, 2013

In my experience, all Wellens' with significant myocardial infarction have evolution from type A waves to type B waves over 6-24 hours' time , so that the presence of type A or type B waves, I believe, are simply a matter of the timing of recording and the rapidity of evolution. Am Heart J (1989) 117 : pp 657-665. de Zwaan C.,

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Chest Pain Myocardial Infarction Ischemia Angina 52

Open Heart

JANUARY 31, 2022

Objective Coronary angiography (CA) and percutaneous coronary intervention (PCI) is of great importance during non-ST-segment elevation myocardial infarction (NSTEMI) management. Coronary artery lesions and their association to mortality in elderly patients with NSTEMI was investigated.

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Myocardial Infarction Stenosis Angioplasty Heart Disease 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

Electrocardiographic Manifestations: Acute posterior wall myocardial infarction. Posterior myocardial infarction: the dark side of the moon. New electrocardiographic criteria for posterior wall myocardial ischemia validated by percutaneous transluminal coronary angioplasty model of acute myocardial infarction.

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Chest Pain Myocardial Infarction STEMI Ischemia 52

Dr. Smith's ECG Blog

OCTOBER 26, 2011

Here is some older but very interesting literature on TIMI myocardial perfusion grade and ST resolution : 1. Determinants and prognostic implications of persistent ST-segment elevation after primary angioplasty for acute myocardial infarction: importance of microvascular reperfusion injury on clinical outcome.

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STEMI Chest Pain Myocardial Infarction Angioplasty 52

Dr. Smith's ECG Blog

APRIL 18, 2024

Refractory ischemic chest pain continued and trop increased to 160,000ng/L, with subtle convex anterior ST elevation: The patient was brought back to cath lab for stenting of LAD and balloon angioplasty to OM. Clin Cardiol 2022 4. Herman, Meyers, Smith et al. Eur Heart J Digital Health 2024 5. McLaren and Smith.

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Dr. Smith's ECG Blog

FEBRUARY 8, 2015

Management of cocaine-associated chest pain and myocardial infarction: a scientific statement from the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology. Henry Ford Hospital. Henry Ford Hospital. Potentiation of cocaine-induced coronary vasoconstriction by beta-adrenergic blockade.

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Tachycardia Chest Pain Pharmacology Myocardial Infarction 52

Dr. Smith's ECG Blog

JANUARY 1, 2013

New electrocardiographic criteria for posterior wall acute myocardial ischemia validated by a percutaneous transluminal coronary angioplasty model of acute myocardial infarction. Am J Cardiol 2001;87(8):970-4. Matetzky S, Friemark D, Feinberg MS, et al. J Am Coll Card 1999;34(3):748-53.

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STEMI Ischemia Chest Pain Myocardial Infarction 52

Dr. Smith's ECG Blog

JUNE 18, 2013

Acute Myocardial Infarction Due to Left Circumflex Artery Occlusion and Significance of ST-Segment Elevation. Impact of delay to angioplasty in patients with acute coronary syndromes undergoing invasive management: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial. Marti D et al.

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STEMI Chest Pain Myocardial Infarction Webinar 52

Dr. Smith's ECG Blog

JUNE 28, 2018

Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. Am Heart J. Am Heart J.

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Chest Pain Myocardial Infarction STEMI Article 52

Dr. Smith's ECG Blog

MARCH 9, 2023

Read our recent editorial: Hyperacute T-waves Can Be a Useful Sign of Occlusion Myocardial Infarction if Appropriately Defined. Relationship between an in-farct related artery, acute total coronary occlusion, and mortality in patients with ST-segment and non-ST-segment myocardial infarction. Pol Arch Intern Med.

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Chest Pain STEMI Myocardial Infarction Blog 52

Dr. Smith's ECG Blog

MARCH 13, 2023

Peak trop ＞ 50,000 ng/L Formal Bubble contrast echo Severe LV systolic dysfunction.

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Chest Pain Myocardial Infarction Angioplasty Thrombosis 52

Dr. Smith's ECG Blog

MAY 10, 2023

ng/mL This single initial troponin at this level, in the context of chest pain, is high enough to be diagnostic of acute myocardial infarction. INTERVENTION * Successful angioplasty and stenting (drug eluting) of the mid LAD * Successful angioplasty of the ostial 1st diagonal Learning points: 1.

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Coronary Angiogram Chest Pain Stenosis STEMI 52

Dr. Smith's ECG Blog

OCTOBER 24, 2019

Spontaneous coronary artery dissection Dissection of a coronary artery may occur in the context of atherosclerosis, or be iatrogennic during angiography or angioplasty. Revascularization in Patients With Spontaneous Coronary Artery Dissection and ST-Segment Elevation Myocardial Infarction. This case occurred 10+ years ago.

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Dr. Smith's ECG Blog

APRIL 8, 2022

Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients. In the setting of evolving infarction — development of AIVR often heralds the onset of reperfusion ( following thrombolysis, acute angioplasty, or spontaneous reperfusion ).

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Dr. Smith's ECG Blog

APRIL 17, 2023

Next trop 85,528 ng/L (consistent with a massive myocardial infarction), none further measured. LCX: minimal luminal irregularities RCA: minimal luminal irregularities Aspiration thrombectomy and PCI performed with resultant TIMI 3 flow in LAD and D1. 1824 post cath: Mot much different than the ECG above, but QOH: "OMI, Low confidence."

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Open Heart

MARCH 3, 2025

Background Drug-eluting stents (DESs) have become the gold standard of coronary angioplasty since their inception in 2002. Biodegradable polymer DESs (BP-DESs) have been postulated to be superior to durable polymer DESs (DP-DESs) due to their more biocompatible polymer. Results Mean age was 67 years, with 75% male.

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DAIC

MARCH 13, 2024

milla1cf Wed, 03/13/2024 - 16:52 March 13, 2024 — In the largest randomized clinical trial and first of its kind to date in the United States, a team led by investigators at Beth Israel Deaconess Medical Center (BIDMC) assessed the efficacy and safety of using a drug-coated balloon in patients undergoing coronary angioplasty. percent).

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Cardiology Update

MARCH 25, 2024

Among the patients included, those with diabetes exhibited higher rates of adverse events, including death, spontaneous myocardial infarction (MI), and repeat revascularization. Pooled data from four trials were analyzed, encompassing patients undergoing PCI or CABG for left main disease.

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Diabetes Coronary Artery Bypass Graft Outcomes Coronary Artery Disease 122

MIBHS

MARCH 31, 2025

A heart attack, or myocardial infarction, happens when an artery becomes blocked, reducing blood flow to the heart muscle. Understanding the difference between heart attack and cardiac arrest can help in recognizing symptoms, seeking prompt medical care, and even saving lives. What is a Heart Attack?

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Circulation

MARCH 11, 2024

Patients with diabetes experienced higher rates of 5-year death (158/1104 [Kaplan-Meier rate, 14.7%] versus 297/3289 [9.3%];P<0.001), spontaneous myocardial infarction (MI; 67/1104 [6.7%] versus 114/3289 [3.7%];P<0.001), and repeat revascularization (189/1104 [18.5%] versus 410/3289 [13.2%];P<0.001).

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Coronary Artery Bypass Graft Diabetes Coronary Artery Disease Stent 81

Dr. Smith's ECG Blog

JUNE 8, 2023

Evaluating clinical reasons and rationale for not delivering reperfusion therapy in ST elevation myocardial infarction patients: insights from a comprehensive cohort. Infarct size and myocardial salvage after primary angioplasty in patients presenting with symptoms for <12h vs 12-72h. Int J Cardiol 2016 3.

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Chest Pain STEMI Bradycardia Myocardial Infarction 86

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Widimsky P et al. O'Gara PT, Kushner FG, Ascheim DD, et al.

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Dr. Smith's ECG Blog

NOVEMBER 19, 2014

See this article by Widimsky: Primary angioplasty in acute myocardial infarction with right bundle branch block: should new onset right bundle branch block be added to future guidelines as an indication for reperfusion therapy [link]

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Circulation: Genomic and Precision Medicine

SEPTEMBER 27, 2023

years, 13 538 participants had incident CAD (myocardial infarction, coronary artery bypass grafting, or coronary angioplasty).Results:TheLPAregion Plasma Lp(a) levels were measured and a CAD-PRS was calculated using the LDpred2 algorithm. Over the median follow-up of 12.6

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Coronary Artery Disease Coronary Artery Bypass Graft Myocardial Infarction Angioplasty 40

Circulation

NOVEMBER 11, 2024

to 10% of percutaneous coronary interventions (PCI), no-reflow is a complication associated with poor outcomes like myocardial infarction extension and death. Circulation, Volume 150, Issue Suppl_1 , Page A4139207-A4139207, November 12, 2024. Background:Occurring in 0.6%

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Myocardial Infarction Angioplasty Pulmonary Arrhythmia 40

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

The lesion was intervened on with balloon angioplasty and had subsequent TIMI 3 flow. Acute myocardial infarction in patients with dialysis Patients on dialysis have a well studied history of underdiagnosis and undertreatment for acute myocardial infarction. There was initially TIMI 0 flow. What can we learn?

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Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

Dr. Smith's ECG Blog

OCTOBER 22, 2024

Successful primary angioplasty of the mid-circumflex artery towards the main marginal branch with the implantation of a drug-eluting stent. Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients. Good angiographic result.

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Chest Pain STEMI Myocardial Infarction Angioplasty 65

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

Primary angioplasty in acute myocardial infarction with right bundle branch block: should new onset right bundle branch block be added to future guidelines as an indication for reperfusion therapy? Upon successful and timely reperfusion, the patient may regain function of the previously ischemic or stunned fascicles.

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Dr. Anish Koka

MAY 16, 2023

Women also had more cardiovascular risk factors, including hypertension (66.6% versus 63.2%; P <0.001), hyperlipidemia (68.9% versus 66.3%; P =0.004), older age (62.4±7.9 years of age versus 59.0±8.4 years of age, P <0.001), cerebral or peripheral artery disease (6.2% versus 4.7%; P <0.001), family history of premature CAD (34.6%

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Chest Pain Coronary Artery Disease Cancer Heart Attack 52

Wellnest

JULY 19, 2023

When one of these arteries becomes completely blocked by a blood clot, it results in a heart attack, also known as MI (Myocardial infarction). When a person experiences a heart attack or myocardial infarction, they may feel chest pain and other symptoms in different parts of their body.

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Heart Attack Heart attacks Blood Pressure Myocardial Infarction 52

Heart BMJ

OCTOBER 28, 2024

Using the Swedish Coronary Angiography and Angioplasty Registry, we included all patients with CCS undergoing coronary angiography in Sweden between 2010 and 2020. In the win ratio analysis, the components of NACE were ranked as follows: (1) all-cause mortality, (2) myocardial infarction (MI), (3) bleeding and (4) urgent revascularisation.

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Angioplasty Myocardial Infarction Outcomes 59

Frontiers in Cardiovascular Medicine

MARCH 17, 2025

Initial diagnostics indicated non-ST-elevation myocardial infarction, leading to immediate intervention. A combination of balloon angioplasty, stent implantation, and intra-arterial thrombolysis with recombinant tissue plasminogen activator (rt-PA) was employed, resulting in significant thrombus reduction and improved coronary flow.

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Coronary Artery Bypass Graft Thrombolysis Coronary Artery Disease Myocardial Infarction 52

Dr. Smith's ECG Blog

APRIL 2, 2025

A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. Am Heart J 2000;139(3):4306.

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